Employment/Job Application

waveGUARD® Employment/Job Application

Date

Date of application

Full Name: *

First, Middle, Last Name

Street Address *

Apartment/Suite

City *

State *

Zip Code *

Email *

Phone *

Date Available

Social Security Number (SSN): *

Desired Pay

Postion Applied For *

Employment Status *

Full Time

Part Time

Seasonal

Employment Eligibility

Are you legally eligible to work in the U.S.? *

YES

NO*

Have you ever worked for this employer? *

YES

NO*

If yes, write the start and end dates

Have you ever been convicted of a felony? *

YES*

If YES, Please explain

Education

High School

High School City

High School State

High School Zip Code

High School Year Start

High School Year End

Graduate?

YES

Diploma

College

College City

College State

College Zip Code

College Year Start

College Year End

Degree/Certification

Previous Employment

Employer 1: (Company/Individual)

Employer 1 Email

Employer 1 Phone

Employer 1 Street Address

Employer 1 Aptment/Suite

Employer 1 City

Employer 1 State

Employer 1 Zip Code

Employer 1 Starting Pay: $

Employer 1 Employment Status

Hour

Salary

Employer 1 Ending Pay

Employer 1 Ending Status

Hour

Salary

Employer 2 Job Title

Employer 1 Job Responsibilities

Employer 1 Dates of Employment: Please include start date and end date

Employer 2: (Company/Individual)

Employer 2 Email

Employer 2 Phone

Employer 2 Street Address

Employer 2 Apartment/Suite

Employer 2 City

Employer 2 State

Employer 2 Zip Code

Employer 2 Starting Pay: $

Employer 2 Employment Status

Hour

Salary

Employer 2 Ending Pay

Employer 2 Ending Status

Hour

Salary

Employer 2 Job Title

Employer 2 Job Responsibilities

Employer 2 Dates of Employment: Please include start date and end date

Military Service

Are you a veteran?

YES

Military Branch

Military Rank at Discharge

Military Dates of Active Duty

Military type of Discharge

If not honorable discharge please explain

Background Check Consent

If asked, are you willing to consent to a background check?

YES

Disclaimer

Applicant understands that this is an Equal Opportunity Employer and committed to excellence through diversity. In order to ensure this application is acceptable, please print or type with the application being fully completed in order for it to be considered. Please complete each section EVEN IF you decide to attach a resume. I, the Applicant, certify that my answers are true and honest to the best of my knowledge. If this application leads to my eventual employment, I understand that any false or misleading information in my application or interview may result in my employment being terminated.

Application Submission Date *

Signature

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